Wednesday, October 12, 2011

Big Pharma delivering too little



The healthcare cost is increasing at an alarming rate. It is unsustainable as prices increased 3 times the inflation rate year after year. The reasons lie in the laws and regulation enacted and accumulated thru the years.

Reducing the cost of healthcare is so important to  keep Medicare alive for generations to come. There is a need to tie the healthcare prices to the economical activities once and for all.

Many of our laws, open market, allow the Pharmaceutical Companies to price their medications in the United States twice or more the prices of Canada, England, and ten times of China, India, etc.
The patent laws protect the pharmaceutical companies from the generics competition for the duration of the patent.

Same medications with an additional patent time protection are always attempted by the Pharmaceutical companies.  Many techniques are used to extend the patent time such as change the delivery system of medication or create a combination with another medication to form new entity which is really not new.

Big Pharma focus on placing their patent protected items in the hospital pharmacy formulary and expel the generic, a cheaper alternative, of the formulary. The patients is discharged from the hospitals with a prescription of high cost brand name items. Since the hospitals rely heavily on Medicare and Medicaid, one can conclude that the focus is on this direction.

The law also allowed “Pay to Delay delaying the generics from coming to the market and continue with the high prices of the brand name for an additional period.

Orchestrated efforts by the pharmaceutical companies to keep their brand name medication, with its highest cost, in the eye of the public for as long as they can. As “Lipitor” patent to run-out soon, a study was conducted aimed to proof that “Crestor” is more superior to Lipitor. This is timed to move the market from Lipitor brand to Crestor brand instead of Lipitor’s generics. The cost reduction from brand to generics is from $2000/year to $300/year, or billions of Dollars. Please note that the study is timed for now not earlier.

The FDA protects the public health regarding medications available in the market and any new medication coming to the market.  With this authority, many medications have come to the market approved for that purpose. But  years later, The FDA come back to withdrew part of the approval for the medication use, or place a black Box  warning on the use of the medication which render it non profitable.  After many years of use and tens of billions of dollars of profit, the medication is withdrawn or used rarely. However there were no consequences to this action to the pharmaceutical companies and those who carried the trials and profited greatly of the medication.  

Classification of the medications is also left to the Pharmaceutical companies and its interest by placing their medications in the RX Class or the OTC class. The RX class medications have 12 folds the prices of the OTC. The RX class also includes the cost of obtaining the prescription, Doctor’s visit, Insurance coverage, Co-Pay, etc. which is additional 5 folds of the prescriptions’ cost. In another word, the possibilities for revenue are in the RX class not in the OTC.

Advertisements by the pharmaceutical companies give the false hope to the patients who in turn asked their physicians to write a prescription for the items seen on television. As you watch the end of the advertisement, it indicates to the professional, not the regular populous, how serious this medication is and the danger associated with it. Death, Behavioral changes, Suicidal thoughts, High Blood Glucose, Low White Blood cells count, and other serious consequences are listed in this advertisement. Patients see the first part of the advertisement only due to the hope for cure.

Promotional techniques are used extensively by the pharmaceutical companies to market their medication through the Physicians’ offices, with samples, lunches, gifts, etc. in order to start the patient on their items and soon they have to buy the higher cost brand name medication. A $300 Lunch provided to healthcare professional capture the full hour of 30 individuals for what they want o tell about their medication.


Pharmaceutical Companies’ sales forces visit hospitals twice a day to promote their medication to the max, lunches, dinners, and continue education by representatives of their own companies.

Various physicians and speakers are on the payroll of the pharmaceutical companies, with compensation of hundred of thousands of dollars to promote the various items, are not to disappoint the payer.

The Pharmaceutical companies’ profit occurs from marketing the current available medication rather than R & D which is drying out. Big Pharma will just buy smaller companies with medication to go back and market the items in the very comfortable market in the United States with higher prices and profit out of this world.

Pharmaceutical Companies’ Research and Development spending is half the spending on marketing programs. With the cost of marketing is relatively low, the gap between marketing and R&D widens.

No Contractual agreement between Medicare and pharmaceutical companies for pricing the medication reasonably depending on the volume of utilization, nor any similarity with Europe when it comes to pricing.

The bulk of healthcare Insurance and cost is carried by the Medicare and Medicaid parts. People are living longer and the cost that is out of control creating a major problem to USA economy which is the only Country facing such a problem.

The private healthcare Insurances are covering young, healthy working individuals and as health deteriorates, it is passed to the Medicare system, which is the Tax Payer program.

There is no mechanism in place or consumer advocacy agency to control the healthcare cost such as arranging for certain medication to be in OTC, behind the counter, or in a new class as in this patent.

The American Medical Association complained repeatedly from the high cost of pharmaceuticals. Since the Pharmaceutical companies price their medication so high, other Medical services compete by pricing their services as high as possible. Then comes new medication to be priced based on the cost of hospitalization and other medical services which make the endless cycle of who can get more money out of the market.

There is a need for actin to change the system slightly, to connect the Healthcare cost and services with the economics of the United States of America. Accordingly prices will rise and fall depending on the economic condition like every- thing else. Housing, cars, Oils, various businesses are connected with the rise and fall of the economic activities and that should include the 16% of the GDP, Healthcare.

Raising the taxes on rich people eventually comes back to rich people again. However, healthcare services can raise prices without any competition,  the money will end up going to rich people or companies only associated with the healthcare business.

So we need  a change in the system and that is what the patent is for "Modification of the medication delivery system, "RPhX".

Sunday, September 25, 2011

The Patent- RPhx

Explanation of the Patent-RPhx

  1. Creating this class will indicate to the various industries and to the Country the clear intention to correct the outrageous prices of medications and price increases in the Healthcare services.
  2. Naming and identifying this class will establish a change in classification and identify the rules that cover this class and these items. RPhX stands for  “RPh” is registered pharmacist and “X” for prescription.
  3. Freely importing medications by individuals and organizations from International sources will eliminate price protection provided to the pharmaceutical companies. This will level-down the prices to be similar to other countries and eliminate the price fix by pharmaceutical companies or any other organizations that dispense these prescriptions in US market.
  4. It also connects to other healthcare services, particularly pharmaceuticals to market forces influencing prices.
  5. Pharmacist added to the mix of those who prescribe these items and or extend the current prescriptions will help in reducing the amount of medication dispensed, and the frequent visits to physicians’ offices with high fees for obtaining these medications time and time again.
  6. No Healthcare Insurances involved will take “fix Co-Pay” out of the mix, and the prices would be what the market cost plus profit.
  7. Since these medications are the smallest strength of the RX medication, as the prices of the items greatly reduced, this will impact other prices to correct slightly.
  8. The price multipliers of other services based on the medication exaggerated prices will adjust downward as the new open market forces influence prices  

Saturday, September 24, 2011

Economics-5-

Emailed 1/14/2011

I would like to just highlight the following issues in economics for this year.

The Federal Reserve have pumped 2.5 Trillion Dollars in the economy to get it going since the start of this Crises. Yet latley, due to the fact that unemployment is still high 9.7%.. they decided to continue pumping an additional 600 Billion Dollars until June 2011.

What does this mean.. It means that the Feds is adamit to improve the economy no matter what, and accordingly the stock market as well.

Bernanke annouce that the GDP for the year 2011 will be between 4-5 %   which is very bullish.
The problems in Europe is huge and every body knows that, however no body knows what is the next step for it. Germany, Japan, and China decided to help as well to stablize the situation in Europe.

The last unemployment report came out to be 9.4%, my estimate by the end of the year woud be 8 Plus which is considered heaven.
People will start go back shopping to a great extent, prices would be leveled to a reasonable low prices in most items.

Housing has a great back log of forclosures which will take many years to clear it and with that the banks can spread the losses over so many years. The prices of houses may decrease slightly, some more than others due to the fact that many jobs lost use to pay higher salaries.

Income will not increase that much as the fear was deflationary all through and according minor increases in income will be happening this year.

As demand start increases, businesses will start hiring again and it seems that this year the market can go up 10%.
This could be investment from money coming from China, Europ, Japan
.
So What to do.
Diversify, diversify
Add some to Mutual funds or Stock index account which is formed of stock, and less on the Fixed intrest account or cash reserved
Bond and Mutual Bond became priciy since more money flooded these bond in the past couple of years.

Don't do something your not comfortable with.
If you thing difrently you may be right as well.
The market in one year can go up, down or side ways and those who did any thing could be right at one point.
Buy and hold now in my mind would be one year and then review it again as if you are buying and holding again.
It is a fast moving change in the economy and accordingly is the market.
That is my story and I am sticking to it.
Good luck.
Nazeeh

Economics (4) 10/15/2008

Emailed on Wed, 15 Oct 2008 12:31:32

Hi All



"This day I call Heaven and Earth as witnesses against you that I have set before you life and death, blessings and curses. Now choose life, so that you and your children may live"

Economics,
Last month had seen something never happened in the past history of the United States of America and the World in the Magnetitude and acuity in Economics.

      The past month, two big financial Institutions have went bankrupt. Bear Stern was sold to another Institution over that week end for a $2/Share. Last year Bear Stern shares were $180/Share......   You can Immagine.

This followed by Lehman Brothers, this time no body interfere to save it and it fell fast and Hard.

       Then the Government Interfere to help AIG, the largest Insurence company in the World with 85 Billion Dollars, hoping that it recover and operate orderly. AIG assats are in the Trillions

       If that wasn't bad enough, The Government came up to Gaurantee Fannie Mae and Freddie Mack, that blows the mind for two reasons.
First, These two institution deals with more than 6 trillion dollars in mortgages etc.
Second, I don't know what cause this action, and it seems that no body else knows, however you can immagine all the talk about Sub-prime, Housing bubble, etc may be behhind....

      Then WaMu, the largest bank in USA was  sold to  JP Morgan Chase after the FDIC interfered to protect the public The bank was FDIC insured and the FDIC took it over and sold it.
Followed by Wachovia,which was sold to Citi with Government gaurantees....
Merril Lynch was sold outside this pack.

Financial Institutions are trying to Delaverage the previous over Lavarages that they done in the past


      The US Legislature passed a law to Bail out of the Toxic assats for about 700 Billion Dollars just last week.

       Today, a collaborative efforts of USA, Europe, Asia, to lower the intrest rate to boost the economic activities in the world basically, which never happened in the past.

       Iceland nationalized two large troubled banks, England and Europe are attempting to do something to their situation with estimated same 700 Billion Dollars. Switzerland banks has much more than the GDP can cover

What does this means?

Hold on to your Pants.. .......
The coming few months will be very difficult for a lot of people very close to us, Jobs will be lost,
Last month was 159,000 jobs lost, etc more to come which is realy the high paying Jobs in addition  slow down of economics world wide....

Oil prices went down to $88 from few month earlier of $147
This is more than 60% depending on the calculation... One would say this is good, it is, but is a bad indication of slow economics Big Time

Many of the Economists are talking about Economic Curve "Tub like" which means steep downturn then flat bottom for sometime.

Housing is down, down, down... pricess has been exagerated before and now is deflating and in the process of being deflated.

Robert Shiller from Yale who have a National Indicator named after him said the prices of houses will drop more than 20% more than the past which was 30%.

Note their is 2 Markets in housing, New Homes, and Existing Homes (controlled by your desire of money you want for your property, the
Real Estate enthusiasm, and seller availability)

For existing homes their is 2 Markets one has 11 Month in the market and the other is awaiting the first market to start moving so they can jumb in with Both feet.

Auto Industry... same problems, SUV no buyers, oil prices killed the large cars and the Car for the
near future is not available. Electric, Hydrogen, Natural Gas, Solar, Gas-Electric, nothing is clearetc.

Hold on to any Capital Improvement at this time...Keep some reserve for the rainy Days.

The rules are changing, the coming few months will be difficult for many who are closer to us.

My coworker told me she lost $100K, that was last sunday, before the Dow went down to 8400. Everybody in the world will be impacted, loosing money in Investment, Car Prices, House Prices, Goods, etc or if you kept the money under the BALATTA (MATTRESS)

I hope I didn't scare everybody, it is what I saw and I think is happening and I thought a little advise may keep everyone safe.

Last Thanks Giving, Someone said it is not a Turkey we are eating, it is a large Chicken. Who New?

I am going to send this Email quickly and hope we are all enlighted
Nazeeh

Economics-(3) 7/20/2008


Sun July 20 2008
Hello Family

With the Stock market doing that bad, I thought it would be a good idea to summarize what is happening.

The Dow Jones Industrial DOW, reach 14,100, soon there after went down slowly and surely to 11, 300 by today. This occurred due to slow earnings, and  more losses particularly with the Banks in USA and around the Globe. Oil, Wheat, Corn, Rice, and other commodities' prices shut up, and on the other hand a slow economy and rise in the unemployment is happening in front of our Eyes.  Accordingly the robust DOW started loosing steam and now is 3000 points from the high, a similar level of June of 2006. The DOW is considered in a Bear Market since it dropped down more than 20 % of the high.

The future of the DOW may be further down due to so many factors that currently happening.

This happened before,  In 1999 before the presidential election of 2000, the DOW took a dive from 11000 Plus to almost 7500, and as the economy started picking up under J. Bush, the DOW moved up etc...

This time it looks like a repeat to what happened before. Yet there is a little twist.

Stagflation may be in the work. High inflation, High Intrest Rate, and slow economics. GM, and Ford, decided to stop manufacturing certain Guzzlers and move to energy saving, Cross, and Hybrid cars with so much pain, Layoffs, market share, profit down. This should have happened 15 years ago.

The commodities are causing inflation world wide. Oil, Corn, Wheat, Rice, Eggs, Milk, Meat, etc.

US economy slowed down and it may take 2 years to pick up the previous speed of GDP 3-5%.
UK started slowing down with similar housing problems occuring. Japan, Europe also started slowing down and some expect the rest of the world, China and India to follow.

Now what to do?

No body knows exactly what to do. In order to support my theory that no body knows, there is 2 examples I have for you.
First: The founder of Country Wide, Mazolla, had Millions of shares that he could have sold them a year ago for over $40 and now is approximatley $5 per share.
Second: The head of Bear Stern, had millions of shares which sold them recenly for 50 Million Dollars. Had he sold them a year earlier he would have been a Billionaire. from $ 180 to $10 a share.

No body knows what can happen a year from now, but the commentators see slow down in economics, and Higher prices world wide. The oil prices also pressuring every body who drives a car, heats a home, etc
The oil crisis has a solution if those who are in charge took action to do the right thing. However, those who has money, don’t care what they pay for their cost, impacting those who don’t have and unable to pay for theirs… Accordingly, we all will pay for it dearly. Now it is the time to buy smaller cars, conserve energy all around it, and support the measures that help solve this crisis.

The Government will start stimulating the economy as soon as a new president start and the policy will be more clear for businesses to invest under the new administration. This will take almost a hear and a half for the economy to pick up speed.   However, this time there is a problem that may complicate life


Inflation in China, India, Europe, and America etc just too much and accordingly, Central Banks of these countries will raise the intrest rate to slow down the inflation and that will lead to recession Big Time, and World Wide. a slow down on the economy is happening as we speak.

The sub prime cost so far is 401 Billion Dollars write offs world wide, and impact is a trillion Dollars including losses on the shares of Banks, Real estate, Builders, etc.

Also, every decade or so, the market eliminate the extra money that has been thrown in investment without care, printed by so many countries and end up in USA, or Japan, China… etc

In the Eighty’s, Japanese bought Rockefeller Center for 1.2 Billion Dollars, few years later sold it for 750 Million Dollars

China bought almost 9 Trillion Dollars of US treasury, and now with the Dollar down 20%, you do the math. They lost 20% of their Debt.

The Sub prime issue took out almost one trillion Dollars and every body is waiting for the end of this problem. We all are paying for it.

House Prices will take more time just to reach what it was in the hype of 2005. Prices in general will continue to go down until the new cost of oil is built in the mix.

For 401K, what you contributes now may loose some of its value as the DOW move down. In case the Dow moves down, and the opposite is also true.

1-The stock market is losing steam, however your contribution is going in regardless. You don’t have control over what time your contribution enter the market. To control the process, have your contribution enters into the Fixed Interest Account. So what you contribute does not loose its value, may not make that much, but it is better to make 3% a year than loosing 10% or more.

2- When you started this 401 K you had certain choices that was good at the time, this may have changed big time today. Real Estate, Builders, Banks, Financial Inst have lost so much and now the time is different.

3- Estimate how long would it take for the stock Market to recover and starts moving up again. You can figure this out by watching certain television Channels. Today I say by the end of 2009, after reaching around Dow 9000. No doubt I can be wrong. But this is my strategy for now, which may change in 6 months.

4- As the Market starts to move upward, you can switch your money to Stock Index, which guarantees better return than many other alternatives.

5- Take control of your own finances, when you contribute, when you stay, and when you move money around. Time changes and you should change your style also. Please note there is some limitation of moving the money so check with your company.

 Send your questions  or your fantastic Gains    
Nazeeh                                   

 

Wednesday, September 21, 2011

Mark-Up of Medications... A real Nightmare



The prices of medications in the United States are at least twice the  prices in Canada and other European Countries. It is ten times the prices in China and India.
       Healthcare services, including Physician visits, X-Ray, Ct-Scan, hospital services... are based as a multiplier of the medication prices. The new medication, Provenge, helps extend the life of the Prostate Cancer patient for four months under treatment costs $90,000 per treatment. This will raise the cost of other healthcare services to match the high cost to a new level.

It is against the law for individuals and Companies to import medications from international sources. With that is in mind, Pharmaceutical companies priced their medication the way they want, with full knowledge that you can't import same medication from someplace.

        Now the laws started to change regarding Marijuana, a serious change in the psyche of this country.

Why can't we change the law regarding importation of medication so as the cost of medication in the United States be similar to the rest of the world, like every other products?

When the prices of the medications adjust downward, so is the rest of the multipliers....

A link to the site that has some information about the Mark-Up of medications.

http://www.chiro.org/LINKS/ABSTRACTS/The_Real_Cost_Of_Drugs.shtml