Drug Companies Increase Prices in Face of Change

Drug Makers Raising Prices Before Reform - NYTimes.com

Even as drug makers promise to support Washington’s health care overhaul by shaving $8 billion a year off the nation’s drug costs after the legislation takes effect, the industry has been raising its prices at the fastest rate in years.
In the last year, the industry has raised the wholesale prices of brand-name prescription drugs by about 9 percent, according to industry analysts. That will add more than $10 billion to the nation’s drug bill, which is on track to exceed $300 billion this year. By at least one analysis, it is the highest annual rate of inflation for drug prices since 1992.

Newsweek story on bipolar disorder

The mothers of bipolar kids often say their babies are born screaming. These are children who live at the extremes: so giddy they can't speak in sentences, so low they refuse to speak at all. Unlike bipolar adults, they flit rapidly between emotions; sometimes they seem to feel everything at once. At least 800,000 children in the United States have been diagnosed as bipolar, no doubt some of them wrongly. The disease is hard to pin down. The bipolar brain is miswired, but no one knows why it develops that way. There are many drugs, but it's unclear how they work. Often, they don't work at all, and they may interfere with normal brain growth. There are no studies on their long-term effects in children. Yet untreated bipolar disorder can be disastrous; 10 percent of sufferers commit suicide. Parents must choose between two wrenching options: treat their children and risk a bad outcome, or don't treat and risk a worse one. No matter what they do, they are in for uncertainty and pain.

States 'recycle' meds to battle costs

The struggle to keep soaring medical costs in check is feeding an increase in state programs that collect unused prescription drugs to give away to the uninsured and poor. Some states allow donations of sealed drugs from individuals, while others only accept pharmaceuticals from institutions, such as doctor's offices or assisted-living homes. Drugs are typically vetted by pharmacists to cross-check safety, then distributed by hospitals, pharmacies or charitable clinics. The type of drugs donated run the gamut and include antibiotics, antipsychotics, blood thinners and antidepressants. At least 33 states have laws to allow or study drug recycling programs, according to the National Conference of State Legislatures. Most state programs are just a few years old or still in the test stages, but officials envision huge gains.

The Case for Another Drug War, Against Pharmaceutical Marketers’ Dirty Tactics

Our Daily Meds begins by illustrating the established drug-company practices that have led to this sorry juncture. There is the rigging of studies, so that to be deemed “effective” a drug need only perform better than a sugar pill. There are the promotional strategies that evade the need for F.D.A. warnings by, say, planting logos for the sexual enhancement drug Viagra and the antidepressant Wellbutrin on Nascar vehicles. There is the co-option of doctors and university researchers by aggressive, payola-dispensing drug company representatives. . . . But she moves to weightier matters in assessing the directions in which heavy drug dependence is leading Americans. First of all there are the business strategies that have created illnesses out of what used to be facts of life, labeled them as syndromes, and have hooked customers into long-term use of medication to cure them. . . . Second, there are the economics of creating chronic consumers for marginally necessary drugs. . . . Irate as she is that in a period (1980-2003) when Americans doubled what they spent on cars they increased their spending on prescription drugs by 17 times, Ms. Petersen steps back to consider the long-term consequences of this shift in consumption. She notes that the first generation of children raised in front of ubiquitous, sunny drug-company advertisements (which became legal in 1997) has acquired the notions that prescription pills fix everything, and that they are less dangerous than street drugs. Then, looking to the elderly, she points out that increasing numbers of drugs are accumulating in these patients, with little regard for the consequences.

Only Severely Depressed Benefit From Antidepressants

While popular antidepressants such as Prozac are widely prescribed for people with varying degrees of depression, the drugs are only effective for those with the most severe depression, a new study suggests. "Although patients get better when they take antidepressants, they also get better when they take a placebo, and the difference in improvement is not very great," lead researcher Irving Kirsch, a professor of psychology at the University of Hull in Great Britain, said in a prepared statement. "This means that depressed people can improve without chemical treatments," he added. . . . Based on these results, there appears to be little reason to prescribe these antidepressants to anyone but the most severely depressed patients, the study authors concluded.

(To read the actual article, go here.)

WHO aims to balance drug companies, poor

GENEVA - The U.N. health chief urged countries on Monday to come up with new ways to make medicine for HIV/AIDS and other diseases more affordable in the world's poorest countries, without stifling innovation among pharmaceutical companies.
The World Health Organization's 193 member states are hoping to forge a global strategy on the highly divisive issues of drug development, patenting and pricing by the end of the week.
"People should not be denied access to lifesaving and health-promoting interventions for unfair reasons," said Dr. Margaret Chan, WHO's director-general, in opening the agency's first meeting devoted to the subject since May, when the United States walked out of a negotiating session and dissociated itself from a WHO resolution.
Under rules agreed by the World Trade Organization, countries can issue so-called "compulsory licenses" to disregard patent rights, but only after negotiating with the patent owners and paying them adequate compensation. If they declare a public health emergency, governments can skip the negotiating.
Brazil and Thailand have invoked the procedure to import cheap generic versions of American AIDS drugs, among other medicines, to treat patients who developed resistance to older anti-retrovirals and needed more expensive, second-line drugs.
The moves by Brazil and Thailand were praised by health campaigners but criticized by industry groups. The United States later placed Thailand on a copyright watch list of nations where American companies face problems protecting intellectual property rights. Countries on the list are under extra scrutiny and can face trade sanctions if alleged violations worsen.
The international aid group Oxfam says compulsory licensing almost never occurs because developing countries face pressure from rich governments acting on behalf of their drug companies. Its report last year on drug access cited WHO statistics that 74 percent of AIDS medicines are still under monopoly, and that 77 percent of Africans still lack any access to AIDS treatment.

Are we too quick to medicate children?

In 2005, the latest year for which statistics are available, at least 2.2 million American children over the age of 4 were being treated for serious difficulties with emotion, concentration, behavior or ability to get along with others. It's a figure mental-health professionals say has exploded in the last decade and a half, along with sales of a wide range of psychiatric medications for use by children.A welter of studies has shown that kids are being diagnosed at younger ages, with a wider range of disorders and with more severe disorders than ever before. And in growing numbers, they are being medicated with drugs whose safety, effectiveness and long-range effects on children have not been demonstrated by extensive research.

Under the influence

For many Americans, a doctor's decision to prescribe medication is something of a sacred transaction. A physician considers the patient and symptoms and chooses the best drug for the job, drawing upon years of training and clinical experience. It is an exchange conducted in a hushed sanctuary, far from the heat and noise of the marketplace -- a place where cool judgment reigns. That sanctuary has been breached. Today, drug manufacturers do everything in their considerable power to ensure that their brand-name prescription medications are on the lips of patients and in the minds of physicians every time the two meet across an exam table. A growing chorus of critics says their efforts have begun to rewrite the dialogue between patient and doctor, influence physicians' judgments and open the act of prescribing to forces more profit-minded than sacred.

Bill Would Let States Force Drug Discounts

U.S. Rep. Chris Van Hollen is preparing legislation that would allow states to make prescription drugs more affordable for low- and moderate-income Americans, a challenge to Bush administration policies that have thwarted such efforts in Maryland and elsewhere.
Van Hollen (D-Md.) said he will introduce a bill early this week allowing states to use their purchasing power to require drug companies to provide discounts on medications for low-wage workers. Under the proposal, states could negotiate the same breaks they get for people on Medicaid, the state-federal health-care program for the poor.

Skipping doses could be deadly

Consider it the other drug problem: Millions of people don't take their medicine correctly — or quit taking it altogether — and the consequences can be deadly. On average, half of patients with chronic illnesses like heart disease or asthma skip doses or otherwise mess up their medication, says a report being issued later this week that calls the problem a national crisis costing billions of dollars.

The Right Rx for Sadness

. . . [T]here's a growing concern that medicine often goes to people who shouldn't be taking it. And a consensus has formed that the estimate of how many people will develop depression at some point—1 in 6—might be greatly inflated. "There's no question that the availability of these drugs has increased the diagnosis of depression," says Jerome Wakefield, a professor of social work at New York University. Wakefield is coauthor of the new book The Loss of Sadness, which argues that selective serotonin reuptake inhibitors—Prozac, Paxil, Zoloft—are commonly overused to treat sadness, a normal and healthy response to divorce, sudden unemployment, the end of a friendship, a house foreclosure.

Backlash on bipolar diagnoses in children

No one has done more to convince Americans that even small children can suffer the dangerous mood swings of bipolar disorder than Dr. Joseph Biederman of Massachusetts General Hospital.
From his perch as one of the world's most influential child psychiatrists, Biederman has spread far and wide his conviction that the emotional roller coaster of bipolar disorder can start "from the moment the child opened his eyes" at birth. Psychiatrists used to regard bipolar disorder as a disease that begins in young adulthood, but now some diagnose it in children scarcely out of diapers, treating them with powerful antipsychotic medications based on Biederman's work.

Psychiatrists, Children and Drug Industry’s Role

[T]he intersection of money and medicine, and its effect on the well-being of patients, has become one of the most contentious issues in health care. Nowhere is that more true than in psychiatry, where increasing payments to doctors have coincided with the growing use in children of a relatively new class of drugs known as atypical antipsychotics.

These best-selling drugs, including Risperdal, Seroquel, Zyprexa, Abilify and Geodon, are now being prescribed to more than half a million children in the United States to help parents deal with behavior problems despite profound risks and almost no approved uses for minors.

Do You Support Prescriptive Authority for Appropriately Trained Psychologists?

Community health centers across the state and the Hawaii Primary Care Association strongly endorse Senate Bill 1004 and House Bill 1456, which address prescriptive authority for certain psychologists. We believe that the requirements outlined in these bills regarding psychopharmacological training, supervised practice, standardized testing, board review and authorization, restrictions on what drugs can be prescribed, and practice only within community health center settings will ensure that patients will be well served rather than jeopardized.