If regional governments keep failing to pay their pharmaceutical bills, "the supply could be cut off," Humberto Arnes, head of the Farmaindustria association, warned on Friday.
His deputy, Javier Urzay, said there are already small pharmaceutical companies that avoid selling drugs to certain regions because of the risk of not getting paid for more than two years. Urzay mentioned Valencia and Andalusia as being among the culprits. For now, though, he insisted, there is no risk for patients because these suppliers are replaced by others.
In the Valencia region, pharmacies went on strike recently to protest the fact that they were not getting paid by health authorities for subsidized prescription drugs. Meanwhile, Catalonia has announced a one-euro charge for patients who get prescriptions from the public health service; the fee will be introduced in May as part of a slew of cost-cutting measures affecting the health sector in the northeastern region.
Spain has already been warned by the Swiss laboratory Roche, which has stopped servicing some Greek health centers. At one point, the company began charging a Castellon hospital for each antitumoral drug it supplied, rather than charging it to the account as before. Another lab, Novartis, included Spain in a warning about the risk of certain countries defaulting on their drug bills.
Regions owe pharmaceutical labs over 6.7 billion euros for medicines sold to public hospitals. Arnes warned that if public spending on health continues to be slashed, things could reach the point where authorities will have to choose which treatments to stop subsidizing to focus on the truly serious diseases.
(CNN -- Scientists say they "serendipitously" discovered that a drug used to treat a type of cancer quickly reversed Alzheimer's disease in mice.
"It's really exciting," said Maria Carrillo, senior director for medical and scientific relations for the Alzheimer's Association. "They saw very positive and robust behavior effects in the mice."
In the study, researchers at Case Western Reserve University School of Medicine gave mice mega-doses of bexarotene, a drug used to treat a type of skin cancer called cutaneous T-cell lymphoma. Within 72 hours, the mice showed dramatic improvements in memory and more than 50% of amyloid plaque -- a hallmark of Alzheimer's disease -- had been removed from the brain.
The study was published Thursday in the journal Science.
Gary Landreth, the lead researcher at Case Western, cautioned that even though his results were impressive in mice, it may turn out not to work in people.
"I want to say as loudly and clearly as possible that this was a study in mice, not in humans," he said. "We've fixed Alzheimer's in mice lots of times, so we need to move forward expeditiously but cautiously."
Mice -- and humans -- with Alzheimer's have high levels of a substance called amyloid beta in their brain. Pathology tests on the mice showed bexarotene lowered the levels of amyloid beta and raised the levels of apolipoprotein E, which helps keep amyloid beta levels low.
Landreth said he hopes to try the drug out in healthy humans within two months, to see if it has the same effect.
Those participating in the trial would be given the standard dose that cancer patients are usually given.
Researchers tested the memories of mice with Alzheimer's both before and after giving them bexarotene. For example, the Alzheimer's mice walked right into a cage where they'd previously been given a painful electrical shock, but after treatment with bexarotene, the mice remembered the shock and refused to enter the cage.
In another test, the scientists put tissue paper in a cage. Normal mice instinctively use tissues in their cage to make a nest, but mice with Alzheimer's can't figure out what to do with the tissues. After treatment with the drug, the Alzheimer's mice made a nest with the paper.
Carrillo said one of the major advantages of bexarotene is that it's already been approved by the Food and Drug Administration for use in humans, which means the researchers can move into human trials sooner than if it were a completely new drug.
The Alzheimer's Association is funding Case Western's next phase of research, which will involve using bexarotene at the levels used on cancer patients, Landreth said. Since the drug does have some side effects -- it can increase cholesterol, for example -- he hopes to use it in even lower levels as the study goes on.
Landreth said his lab had been working on other drugs for Alzheimer's for 10 years when a graduate student, Paige Cramer, decided to try bexarotene, which works on a receptor involved in amyloid beta clearance. Some other drugs that worked in mice were too toxic to use in humans.
"We're really lucky that bexarotene is a great drug with an acceptable safety profile," he said. "This doesn't happen very many times in life'"
Low official wages created a temptation for physicians, who would attract fee-paying patients by falsely categorising them as pregnant women who are exempt from the normal requirement to help pay for their drugs.
Corruption remains widespread, according to doctors, pharmacists and medical suppliers, with direct bribing by suppliers.
“The
fakellaki
system [envelopes containing cash bribes] is still operating at big hospitals in Athens, run by the heads of procurement,” says one Greek executive working for a foreign medical supplier.
Another executive says pharmacists sometimes seek reimbursement by falsely claiming medicines for fictitious or dead patients. Health insurance funds do not require verification that costly medicines are essential, resulting in fraud estimated at up to ˆ1bn a year.
Patent-protected drugs have been sold to the Greek health system in high volumes at prices which are relatively low by EU standards. One consequence was more than ˆ850m last year in “parallel exports” of medicines bought cheaply by Greek pharmacists and resold abroad. The government responded in recent months by banning foreign sales of some medicines after domestic supplies ran out.
Once patents have expired, the lack of any requirement for Greek doctors to prescribe cheaper, generic versions means patented drugs still represent nearly 80 per cent of total prescriptions in Greece, compared with less than 30 per cent in Germany. Yet generics were traditionally sold at relatively high prices, with very low discounts to patented drugs. Even after recent reforms, they are typically only a third cheaper, compared with lower rates of nearly 90 per cent less in the UK.
Vassili Kontozamanis, a former Greek drug regulator, calls for greater efforts to boost generic prescribing at lower prices, but he cautions that such moves are meeting resistance from the country’s powerful generic drug industry, which employs more than 15,000 people.
Recent government reforms have included non-binding prescription guidelines, and cuts in drug prices amounting to ˆ1bn, with the aim of reducing the state’s medicines bill to 1 per cent of GDP by the end of this year. But reforms at state hospitals are making only modest progress amid strong opposition from medical staff.
By Alex Wayne
Feb. 13 (Bloomberg -- Drugmakers led by Pfizer Inc. would have to provide $156 billion in discounts over the next decade for medicines sold to low-income senior citizens under President Barack Obama’s proposed fiscal 2013 budget.
The administration’s budget request, released today, contains a package of changes to Medicare, the U.S. health insurance program for the elderly and disabled, and Medicaid, the health plan for the poor. The policies combined would help save $362 billion over a decade to slow medical spending.
Brand-name drug manufacturers already provide rebates worth at least 15 percent the price of their medicines to Medicaid. The administration is proposing to extend that policy to cover so-called “dual eligibles,” about 9 million senior citizens who qualify for both Medicare and Medicaid.
Because Medicare and Medicaid have different payment programs, Medicare is “receiving significantly lower rebates and paying higher prices than Medicaid” for drugs, the administration said in budget documents.
The drug industry agreed to provide $80 billion in discounts and rebates to help cover the cost of expanded insurance coverage under the 2010 health-care law. The rebates proposed in the budget documents today would come on top of those commitments.
Most people are now aware how the academic literature on medications is undermined, (perhaps fatally for some drug classes such as antidepressants [1] , by publication bias and selective reporting. To these, we must now add citation distortion or “unfounded authority”. Unfortunately, much consensus in psychopharmacology is based on unfounded authority.
Citation distortion [2,3] is the process whereby, in a field with ambiguous primary data, studies showing the desired outcome are preferentially cited. Over years and generations of reviews, this distortion is amplified with exponential increases in supportive citation, facilitated by increased citation of papers that do not contain primary data (ie, one review cites another . At the same time, there is no parallel increase in citation of critical reviews.
Errors accumulate in this process of reiterative citation; for example what is acknowledged as hypothesis in cited articles is misrepresented as fact in reviews.
An example from this week’s academic literature is an article from Australia’s MJA [4]. Amongst the numerous self-citations (count them , note the disingenuous citation of the discredited Gibbons et al paper (see David’s blog at
http://davidhealy.org/coincidence-a-fine-thing as though it supported ‘The importance of managing anxiety and depression in young people to minimise functional, medical and psychological complications’.
[1] Ioannidis JP. Effectiveness of antidepressants: an evidence myth constructed
from a thousand randomized trials? Philos Ethics Humanit Med. 2008 May
27;3:14.
http://peh-med.com/content/pdf/1747-5341-3-14.pdf.
[2] Greenberg S. How citation distortions create unfounded authority: analysis of a citation network. BMJ2009;339doi: 10.1136/bmj.b2680 (Published 21 July 2009
http://www.bmj.com/content/339/bmj.b2680.full
[3] Slawson DC, Shaughnessy AF. Obtaining useful information from expert based sources. BMJ. 1997;314(7085 :947-9.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2126390/pdf/9099121.pdf
[4] Scott EM et al. Targeted primary care-based mental health services for young Australians. MJA 2012; 196: 136-140
http://www.mja.com.au/public/issues/196_02_060212/sco10481_fm.html
Three weeks ago, the National Institutes of Health announced new rules to govern federally-funded researchers and their financial conflicts of interest. Three years in the making, the policy will affect
over 38,000 scientists at 2000 organizations as the NIH attempts to ensure that biomedical research, paid with taxpayer dollars, remains objective.
But none of these changes might have happened were it not for Dr. Charles Nemeroff.
A renowned chairman of psychiatry at Emory University, Nemeroff was a proponent for drugs sold by GlaxoSmithKline, such as the antidepressant Paxil. While earning hundreds of thousands of dollars jetting around the country and giving talks about Paxil to doctors at fancy restaurants, Nemeroff also managed a multi-million dollar grant from the NIH to research drugs under development by Glaxo.
The ensuing scandal became central to an investigation by Senator Charles Grassley into undisclosed payments from companies to prominent physicians—a practice that puts patients at risk and drives up healthcare costs. As Grassley’s lead investigator on the matter, I had a ringside seat as arguably the most powerful psychiatrist in the country was forced from prominence, eventually leaving Emory.
In This Story:
Intro |
Ghosts From The Past |
A History Of Conflict|
Welcome To The Sunshine State|
Mistakes Were Made|
“Couldn’t Be Better“
At my new job with the Project On Government Oversight (POGO , a government watchdog, I have continued to study the cozy relationships between physicians and corporations. I also observed as Nemeroff left Emory for a new job at the University of Miami which has a medical school operating under financial strain. But why would this school snatch up a physician with such a history?
According to new emails and other materials shown to me, UM officials had serious concerns about Nemeroff’s history of ethical blunders. However, these emails suggest that Nemeroff’s perceived ability to raise money trumped those concerns. At one point while negotiating with UM for a job, Nemeroff even dangled the possibility of a new funder for the school if he was hired. These emails imply that, despite new federal rules, the public must remain vigilant to ensure that medicine is practiced with the highest regard for ethics and patient safety.
Officials at UM did not respond to detailed and repeated questions about the emails, which include communications by UM President Donna Shalala, who is now facing public scrutiny over a separate ethics scandal involving UM’s football program.
By Paul Thacker.
 |
Unlike pharmaceutical drugs, natural, whole foods are packed with synergistic nutrients that work together in unity to provide a plethora of health benefits without causing negative side effects -- and walnuts are no exception! A new study published in the British Journal... |
No comments:
Post a Comment