[Winona Online Democracy]
You are right Terri. The amount of money spent on promotion of drugs in a
major part of their cost. My father (bless his sole) was a pharmaceutical
Sales Rep. This was nearly 30 years ago and the role then was one more of
information and education to the health care professionals. Yes, they had
samples and literature and did provided perks to the physicians. Also in
those days one person represented the entire company. Now there are so
many reps for each company, it is hard to keep track of them all. Some
companies have 4 to 6 reps in this area alone. Media advertising these days
also makes up for major costs to the drug companies. TV alone costs a
fortune. While I believe that drug companies need money to do research,
remember that the government and other sources also provide funding for new
drugs and research grants.
Minnesota passed a law several years ago that limits how much money
drug reps can spend on each health care professional and they must keep
track of it. The "trips" are pretty much a thing of the past. We as
pharmacists do get the drug companies to sponsor a dinner speaker once in
awhile to educate us on new drugs and their uses and side effects.
Generally several pharmacists attend and the programs are given by
physicians and other health care providers. These meetings are very useful
to our profession and help us better consult you the patient on the use of
your medications.
As far as who could run the best health care programs? I think the
states should do it. The states have the data bases of the patients and
their usages and would be in the best position to negotiate contracts with
insurance companies and drug companies. Read today's Minneapolis Tribune to
see what effect the drug companies are having already. Dick Gaffron
----- Original Message -----
From: "terri hyle" <[EMAIL PROTECTED]>
To: <[EMAIL PROTECTED]>; <[EMAIL PROTECTED]>; <[EMAIL PROTECTED]>;
<[EMAIL PROTECTED]>
Sent: Saturday, November 15, 2003 11:33 AM
Subject: Re: [Winona] Insurance Execs Bribing Democrats AND Republicans?
> We also need to keep in mind that the current marketing practices for
> pharmaceutical companies significantly drive up prices. There is a
balance
> to be struck between educating consumers and physicians by television
> commercials and promotional materials about the availability of new
> therapies to treat disease and conditions and cost containment. The
truth
> is that agressive marketing practices are designed to garner a larger
share
> of the market--and a larger share of the profits, not to benefit
consumers.
>
> Dick Gaffron can give better, more detailed information, but I was able to
> find the National Institute on Drug Abuse site, listing phases of human
> clinical trials for new drugs.
>
> You should be aware that years of research and development (and expenses)
> take place before reaching Phase 1 clinical trials.
>
> I opened the link as a text doc. but also cut and pasted below.
> Here's the link:
>
>
http://frwebgate.access.gpo.gov/cgi-bin/get-cfr.cgi?TITLE=21&PART=312&SECTIO
N=21&YEAR=2001&TYPE=TEXT
>
> (a) Phase 1. (1) Phase 1 includes the initial introduction of an
> investigational new drug into humans. Phase 1 studies are typically
> closely monitored and may be conducted in patients or normal volunteer
> subjects. These studies are designed to determine the metabolism and
> pharmacologic actions of the drug in humans, the side effects associated
> with increasing doses, and, if possible, to gain early evidence on
> effectiveness. During Phase 1, sufficient information about the drug's
> pharmacokinetics and pharmacological effects should be obtained to
> permit the design of well-controlled, scientifically valid, Phase 2
> studies. The total number of subjects and patients included in Phase 1
> studies varies with the drug, but is generally in the range of 20 to 80.
> (2) Phase 1 studies also include studies of drug metabolism,
> structure-activity relationships, and mechanism of action in humans, as
> well as studies in which investigational drugs are used as research
> tools to explore biological phenomena or disease processes.
> (b) Phase 2. Phase 2 includes the controlled clinical studies
> conducted to evaluate the effectiveness of the drug for a particular
> indication or indications in patients with the disease or condition
> under study and to determine the common short-term side effects and
> risks associated with the drug. Phase 2 studies are typically well
> controlled, closely monitored, and conducted in a relatively small
> number of patients, usually involving no more than several hundred
> subjects.
> (c) Phase 3. Phase 3 studies are expanded controlled and
> uncontrolled trials. They are performed after preliminary evidence
> suggesting effectiveness of the drug has been obtained, and are intended
> to gather the additional information about effectiveness and safety that
> is needed to evaluate the overall benefit-risk relationship of the drug
> and to provide an adequate basis for physician labeling. Phase 3 studies
> usually include from several hundred to several thousand subjects.
>
>
>
> Terri Hyle
>
>
> >From: "Robert P Kaldunski" <[EMAIL PROTECTED]>
> >To: "Dick Gaffron" <[EMAIL PROTECTED]>,"Fellman's"
> ><[EMAIL PROTECTED]>, <[EMAIL PROTECTED]>,"Dwayne Voegeli"
> ><[EMAIL PROTECTED]>
> >Subject: Re: [Winona] Insurance Execs Bribing Democrats AND Republicans?
> >Date: Sat, 15 Nov 2003 09:31:14 -0600
> >
> >[Winona Online Democracy]
> >
> >
> >The Pharmacist have a viable interest in telling the Federal Government
to
> >Straighten out the FDA. I fail to understand the reason for testing
people
> >other than the
> >
> >the intended people who would use the drugs in order to get approval, and
> >why can't the FDA make use of the same approval strategy that is used in
> >other countries to get a drug approved. This would help lower the price,
> >give the Mfg's a better profit while keeping the price affordable to the
> >persons on a fixed income. Bob Kaldunski
> >----- Original Message -----
> >From: "Dick Gaffron" <[EMAIL PROTECTED]>
> >To: "Fellman's" <[EMAIL PROTECTED]>; <[EMAIL PROTECTED]>; "Dwayne
> >Voegeli" <[EMAIL PROTECTED]>
> >Sent: Saturday, November 15, 2003 7:18 AM
> >Subject: Re: [Winona] Insurance Execs Bribing Democrats AND Republicans?
> >
> >
> > > [Winona Online Democracy]
> > >
> > > Just a post from a pharmacy perspective about Canadian Drugs. Some of
> >the
> > > savings we are seeing on drugs from Canada have to do with the
exchange
> > > rate. The manufacturers will point this out also. At last report, the
> > > exchange rate was 75-76 cents giving an automatic 24-25% savings.
Also,
> > > Canadian pharmacies only purchase drugs from the government and the
> > > inventory in those pharmacies is "on consignment". The pharmacies do
> >not
> > > pay for the drugs until they are sold. In contrast, most US pharmacies
> >have
> > > to carry well over $100,000 in inventory to satisfy the needs of our
> > > patients.
> > > The Minnesota Pharmacists Association has taken a position
> >against
> > > the re-importation issue for several reasons. We can argue the safety
> > > issue, but I believe that is a weak point as all the drugs are made is
> >US
> > > factories under FDA supervision. The real point is the inability of US
> > > pharmacies to purchase pharmaceuticals at the Canadian contract
prices.
> >By
> > > allowing the sale of foreign drugs in this country and particularly
this
> > > state, it is suggested by the Pharmacists Association that many
> >Minnesota
> > > Pharmacies would be forced to close. With insurance being generally
> >over
> > > 80% of the business pharmacies do, our margins have shrunk to 1/4 what
> >they
> > > were even 10 years ago. With a national shortage of pharmacists,
labor
> > > costs also continue to rise. Somewhere the "rubber had to meet the
> >road"
> > > and independent pharmacies will suffer the most. The Association
claims
> > > that net profits for pharmacies is only about 2% and the loss of
> >business
> >to
> > > Canadian and other countries would put pharmacies into the red and
many
> >out
> > > of business.
> > > Personally, I think it's time the manufacturers were called to
> >task
> > > and forced to contract with States, as they have with Canada. I think
> >the
> > > states should be the place for these negotiations, not the Federal
> > > government. Each state has unique populations and market influences
and
> > > would be more appropriate. This idea as proposed in Minnesota in a
> > > legislative session a while back, and was soundly defeated by drug
> >company
> > > lobbying. It would be worth a try again. Many people do not know that
> > > non-profit institutions such as some hospitals, nursing homes, and
> >"teaching
> > > clinics" now have group contracts for certain drugs at lower prices.
> > > Sorry for the lengthy post, but I think we need to look at the
> > > pharmaceutical issue from all angles. Finally, pharmacist contact with
> >our
> > > patients is not only essential, but required in most cases. Medicaid
> > > patients must be counseled about their prescriptions. How can a
foreign
> > > pharmacy give you the most accurate and personal information on your
> > > prescription? Your local pharmacies do and in a very professional
> >manner.
> > > All of us are willing to answer questions and if we don't have an
> >answer,
> > > know where to get that answer. Dick Gaffron
> > > ----- Original Message -----
> > > From: "Fellman's" <[EMAIL PROTECTED]>
> > > To: <[EMAIL PROTECTED]>; "Dwayne Voegeli" <[EMAIL PROTECTED]>
> > > Sent: Thursday, November 13, 2003 10:35 PM
> > > Subject: Re: [Winona] Insurance Execs Bribing Democrats AND
Republicans?
> > >
> > >
> > > > [Winona Online Democracy]
> > > >
> > > > In answer to Dwayne's question about why drugs are so much cheaper
in
> > > > Canada...... Could it be that because in their government run,
single
> > > payer
> > > > system that healthcare is rationed and therefore the demand for
drugs
> >is
> > > > low....
> > > >
> > > > Just a thought, no real basis in fact.
> > > >
> > > > Greg Fellman
> > > >
> > > >
> > > >
> > > > ----- Original Message -----
> > > > From: "Dwayne Voegeli" <[EMAIL PROTECTED]>
> > > > To: <[EMAIL PROTECTED]>
> > > > Sent: Thursday, November 13, 2003 10:00 PM
> > > > Subject: Re: [Winona] Insurance Execs Bribing Democrats AND
> >Republicans?
> > > >
> > > >
> > > > > [Winona Online Democracy]
> > > > >
> > > > > (First of all, I aplogize that the mysterious missing e-mails I
had
> >sent
> > > > > over the weekend seemed to reappear from cyberspace limbo. I'm
> >sorry
> > > for
> > > > > clogging up your in boxes with repetitive messages. Others seemed
> >to
> > > have
> > > > > had the same problem. Solar storms? Soviets? Bad e-mail karma?)
> > > > >
> > > > > -----
> > > > >
> > > > > Back to John Finn's and Paul Double's E-mails about Health
> >Insurance.
> > > > >
> > > > > -----
> > > > >
> > > > > John, I think I read the same article you did about the
cash-payment
> > > only
> > > > > doctors. Was it in last week's Wall Street Journal?
> > > > >
> > > > > In any event, it is an interesting idea.
> > > > >
> > > > > You finished by saying, "the debate over what constitutes a living
> >wage
> > > > and
> > > > > which employers are 'good or bad' is muddled by having an
employment
> > > based
> > > > > health insurance system." I completely agree. One of the biggest
> > > winners
> > > > > in a single payer system would be small and medium sized business
> >owners
> > > > > who would get the health care coverage monkey off their backs.
> > > > >
> > > > > (There is a great article about the problems that soaring health
> >care
> > > > costs
> > > > > are causing between workers and business owners in the Business
> >Section
> > > of
> > > > > the Sunday, November 2, 2003 edition of the Star Tribune. I would
> >have
> > > > > included the URL but I can not seem to access their archives even
> >though
> > > > > I'm a subscriber.)
> > > > >
> > > > > -----
> > > > >
> > > > > To Paul Double, you are scaring me. We're beginning to agree on a
> >lot
> > > > when
> > > > > it comes to health care reform.
> > > > >
> > > > > ;->
> > > > >
> > > > > You're also starting to sound like a Teddy Roosevelt Republican.
> >Maybe
> > > > the
> > > > > Republic can be saved from the aristocrats who want to turn it
into
> >an
> > > > > Empire after all.
> > > > >
> > > > > About elections. You can't seperate health care reform from
> >democratic
> > > > > reform (read campaign finance reforms). Until and unless the
> > > Republicans
> > > > > and Democrats support the Fair and Clean Election (F.A.C.E.) bill
in
> >the
> > > > > Minnesota Legislature, we will not see real health care reform in
> >the
> > > > state
> > > > > because super-big drug and insurance corporations own both
parties,
> >at
> > > > > least the tops of both organizations.
> > > > >
> > > > > Publicly funded campaigns first. (they would be voluntary)
> > > > >
> > > > > Health care reform that truly benefits the public second.
> > > > >
> > > > > Again, why are drugs so much cheaper in Canada in the first place?
> > > > >
> > > > > Dwayne Voegeli
> > > > >
> > > > > ==================
> > > > >
> > > > >
> > > > > >From: "John N. Finn" <[EMAIL PROTECTED]>
> > > > > >To: "Online Democracy" <[EMAIL PROTECTED]>
> > > > > >Date: Wed, 12 Nov 2003 05:40:24 -0600
> > > > > >Status:
> > > > > >
> > > > > >[Winona Online Democracy]
> > > > > >
> > > > > >
> > > > > >----- Original Message -----
> > > > > >From: "Paul Double" <[EMAIL PROTECTED]>
> > > > > >To: "Online Democracy" <[EMAIL PROTECTED]>
> > > > > >Sent: 11 novembre, 2003 14:52
> > > > > >Subject: FW: [Winona] Insurance Execs Bribing Democrats AND
> > > Republicans?
> > > > > >
> > > > > >
> > > > > >................. What maybe will be different in the next two
> >years
> >is
> > > > the
> > > > > >fact that the public conservatives, liberals and others appear to
> >be
> > > > ready
> > > > > >to partner at
> > > > > >least on healthcare "solutions". .............
> > > > > >
> > > > > >----- Response -----
> > > > > >
> > > > > >I'm not sure how relevant this is, but I recently read an article
> >about
> > > a
> > > > > >doctor that runs a 'cash at time of treatment' clinic. That is,
he
> > > > accepts
> > > > > >no insurance or third party payments, thus greatly reducing his
> > > paperwork
> > > > > >shuffling overhead costs. His customers include those lacking
> > > insurance,
> > > > of
> > > > > >course, but also some that are covered because his fees are often
> >not
> > > > much
> > > > > >more that the co-pays they would have had to pay in their plan's
> > > network.
> > > > > >
> > > > > >Also, it seems to me that the debate over what constitutes a
living
> > > wage
> > > > and
> > > > > >which employers are 'good or bad' is muddled by having an
> >employment
> > > > based
> > > > > >health insurance system.
> > > > > >
> > > > > >
> > > > > >_______________________________________________
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> > > > > >
> > > > >
> > > > > ------------
> > > > >
> > > > > Dwayne Voegeli
> > > > >
> > > > > Winona County Commissioner, District #2
> > > > >
> > > > > (507) 453-9012
> > > > >
> > > > > [EMAIL PROTECTED]
> > > > >
> > > > > 359 Pleasant Hill Dr.
> > > > > Winona, MN 55987
> > > > >
> > > > > ------------
> > > > >
> > > > >
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