Prescription drugs in the US (a bit long, but you must read the conclusion)

Posted by on

Congress is under pressure to reduce drug prices, but the obstacles are legion. Current federal regulations protect drug makers from competition and restrict the government’s ability to negotiate bulk prices for large purchases from manufacturers. The nation’s drug distribution system is complex, opaque, short on data, and little understood by consumers. And the huge money at stake gives the drug industry every incentive to invest billions into blocking change.

More competition for the name brand drug makers from generic drug manufacturers would help. Generic drugs saved American consumers $227 billion in 2017 alone, by one estimate, but both federal policies and drug industry abuses in the past 20 years have blocked their development. In the U.S., laws meant to promote innovation have given drug makers an unusually long window of market exclusivity that protects their monopolies. The makers of new biologic drugs, for example medicines made from living cells – enjoy exclusive market rights for a dozen years. That’s seven years longer than the exclusivity granted conventional, small-molecule. drugs. A plan to restrict biologics patents and bring them in line with small-molecule drugs would have saved the government just under $7 billion over a decade, but it was anandoned as a result of heavy lobbying.

Lawmakers on both sides of the aisle have introduced more than 30 bills to curb drug prices in the past two years, All have died owing to intransigent opposition from Big Pharma. Ideas include bills to allow the importation of drugs from Canada, more pricing transparency,
tough price negotations, and making patent applicants demonstrate significant differences, originality, or additional benefit to qualify for secondary patents that extend the monopolies. Two sensible and rational ideas are, firstly, “single payer”, the single payer being government, which is the case in other advanced countries. Single payer is supported by more than half of all Americans. Secondly, value-based pricing, the idea being to tie drug prices directly to health care outcomes. The drug company would guarantee patients that its drugs would help them hit specific. markers, or they would get their money back.

But meanwhile pharmaceutical companies get up to all sorts of games, (aside from assisting Congressmen stay in their jobs!),such as:

– “pay-for-delay” agreements, where originators of a drug agree with generic manufacturers (for a price) not to develop a generic drug until a specified date, thus prolonging their exclusivity.
– refusing to sell their products to generic manufacturers for analysis, even when the patent has lapsed.
– refusing to participate with generic drug makers in safety protocols required by the FDA, citing a danger to consumers, but effectively choking off their generic rivals.

I have a chronic sleep problem. Through a sleep doctor I signed up with a company that sells drug called Xyrem, in the hope of finding something that works for more than a month at a time. In the course of organising this I asked the price. $4,750 a month!! Turns out Xyrem is a so-called “orphan” drug, originally designed for quite another condition, then sold on to Jazz Pharmaceuticals to treat (mainly) narcolepsy. In 2007 Xyrem sold for $2.04 per 100 milliliter dose, translating to a out $60 a month. This figureis now $4,750.In 2013 sales of Xyrem were $569 million. Need I say more?

The best democracy money can buy!

Posted by on

Acting Consumer Financial Protection Bureau director Mick Mulvaney is working diligently these days to gut the agency he now heads. But Mulvaney isn’t seeing that same diligence from the financial industry movers and shakers he’s endeavoring so hard to shield. Last week, at a financial industry conference in Washington, D.C., Mulvaney told 1,300 bankers to step up and open their wallets. Noted the former lawmaker: “We had a hierarchy in my office in Congress. If you’re a lobbyist who never gave us money, I didn’t talk to you. If you’re a lobbyist who gave us money, I might talk to you.” Bankers who buy access, Mulvaney essentially pronounced, are engaging in one of the “fundamental underpinnings of our representative democracy.” Or at least representative democracy as defined by Mulvaney, whose $7-million personal fortune sits him comfortably within America’s top 1 percent.
(Inequality.org)

Thus is democracy shamelesly subverted, with the support, apparently, of half the country. Where is the outrage? How can these corrupt people live with themseves? The only positive thing one can say about these crooks is that at least they are open about their corruption. Mulvaney would probably point out that one of the most disastrous and undemocratic Supreme Court decisions of all time – the so-called Citizens United decision – gave the stamp of approval to the purchase of Congressional favors and seats by people with the most money. “Conservatives” would no doubt take me to task for introducing party politics into an Epicurean blog – well, they would, wouldn’t they? They have clear consciences, it seems, and cannot understand that seeing cemocracy and the Constitution subverted so outrageously is deeply disturbing to the rest of us.

American evangelicals: why are there so many of them?

Posted by on

Paige Patterson is president of the Southwestern Baptist Theological Seminary, a Fort Worth school whose website says it is one of the largest seminaries in the world. About 15 million people are part of Southern Baptist churches, the largest Protestant group in the United States. Patterson is slated to deliver the primary sermon — a high-profile honor — in June at the Southern Baptist Convention’s annual meeting in Dallas.

Patterson issued a statement Sunday pushing back after a 2000 tape surfaced purporting to quote him saying that abused women should focus on praying and “be submissive in every way that you can” and not seek divorce. He is heard on an audiotape being interviewed in 2000 about what he recommends for women “who are undergoing genuine physical abuse from their husbands, and the husband says they should submit.”

“It depends on the level of abuse, to some degree,” Patterson says. “I have never in my ministry counseled anyone to seek a divorce and that’s always wrong counsel.” Only on an occasion or two in his career, he says, when the level of abuse “was serious enough, dangerous enough, immoral enough,” has he recommended a temporary separation and the seeking of help.

Patterson has huge stature in the Southern Baptist Convention because he was one of the leaders, starting in the late 1970s, of what his supporters would call “the conservative resurgence” (more liberal Protestants would call it the “fundamentalist takeover”). It was a planned political takeover of the Convention and its institutions by those who believe the Bible is totally free of error.

Patterson in the tape was being interviewed by the Council on Biblical Manhood and Womanhood, an evangelical organization that promotes the idea that men and women have different traditional roles. Efforts to confirm that with the council late Sunday were not successful. Most conservatives were eager to condemn abuse but many also declined to directly name Patterson or address the issue of divorce.

Evangelical Christians have higher-than-average divorce rates in the United States, according to research by Baylor University, a prominent Baptist school. The Southern Baptist Convention has agonized in the past decade over how to respond to this. Entwined through that issue is gender equity, as women are not allowed to be pastors in SBC churches.

The Council on Biblical Manhood and Womanhood tweeted a statement it adopted in March that said physical, sexual or emotional abuse is “not only a sin but is also a crime … that must not be tolerated in the Christian community. The church must offer tender concern and care for the abused and must help them to find hope and healing through the gospel. The church should do all it can to provide ongoing counseling and support for the abused.”

Patterson himself did not dispute the tape but said he was being “subjected to rigorous misrepresentation.” Patterson was president of the Southern Baptist Convention in the late 1990s. In his statement, he said that he has never been accused of abusing anyone, that he has counseled women “on more than one occasion” to leave abusive husbands, and that physical or sexual abuse of any kind should be reported “to the appropriate authorities.” He praised the Council on Biblical Manhood and Womanhood statement and said it reflected his view.

“I have also said that I have never recommended or prescribed divorce. How could I as a minister of the Gospel? The Bible makes clear the way in which God views divorce,” he wrote.

So let us assume that most people believe abuse to be abhorrent. so why are there so many evangelicals, and how can they square their political views, not just with the bible and christian values, but with humanity, decency and loving kindness? How have we reached a point where they call the shots in the Republican world and support policies and attitudes that are anathema to Epicureans and, indeed, to all humane people? Apparently, enrollment at Southwest seminary has nose-dived in the past 20 years, which does offer hope that this evangelic “movement” has at least stopped growing. I have nothing but respect for true christians, but these people do not share that epithet.

The French government and Christianity

Posted by on

The secularist drive to rid France of any hint of its Christian past is becoming “insane”, says Gilles-William Goldnadel. A court has just ruled that a cross atop a statue of Pope John Paul II in the town of Ploërmel in Brittany – sculpted by Russian artist Zurab Tsereteli – must be removed. Apparently it contravened the 1905 ban on religious symbols in public, even though it was plainly just “a symbolic ornament on a work of art”. Or consider the case of the Greek yoghurt pots that Lidl recently put on sale: they were decorated with pictures of Greek villages, but the Orthodox cross on the churches had been photoshopped out by the supermarket chain “to avoid offending anyone”. For the same reason, the Paris transport system refused to let a charity run posters inviting donations for Christians being persecuted in the Middle East. What sticks in the craw is that the authorities are so strict about Christianity, our native religion, yet they positively encourage public religious activity by foreigners – it’s considered fine for Paris’s mayor to stage an event at the taxpayers’ expense to mark the end of Ramadan. The ban on religious symbols should mean more than giving offence to Christians. (Le Figaro, Paris)

It is political correctness like this that help fuel the rise of Trump and the disaster of Brexit. As a follower of Epicurus I don’t belong to any religion (and try not to belong to any tribe). But France has been christian for nearly 2000 years and has an enviable culture. I have no problem with moslems making their homes in the West, especially if they integrate into local life, but suppressing the old ways while pandering to the new is simply crass. It feeds the resentment of the political Right. It was good that Macron won the last election, but waiting in the wings are some very nasty people.

One might conclude that religion is a menace, dividing mankind and still causing wars and communal strife all over the planet. Of course, the truth is that religion is mainly the outward and visible evidence that men and women are tribal, enjoy tribes, dislike other tribes! and feel smug, superior and intolerant about others. I prefer Epucureanism, which is as far from being a tribe as possible, although not without its politics, since there are self-described right-wing Epicureans who are ……. oh, bother! I was just about to be tribal!

Music again

Posted by on

To The Daily Telegraph

“The head of the Royal Philharmonic is making a serious error by believing that abolishing the term “classical music” will suddenly attract thousands of young people into our concert halls. The leadership of the RPO seem to be suffering from a crisis of confidence in their art form – brought on by our society’s obsession with making everything “accessible” or, rather, watered-down.

“Even during the years of Soviet communism, Russian musicians and orchestras – with the encouragement of the state – maintained the most elitist rituals, even when playing before industrial workers in factories, positively rejoicing in classical music and all of its white-tie-and-tails rituals.

“It is very sad that in modern Britain, serious art and culture of all kinds is being dissolved into a supposedly democratised mass of nothingness. That such ideas should come from the RPO – the orchestra of Sir Thomas Beecham – is beyond belief. (Stuart Millson, classical music editor, The Quarterly Review, East Malling, Kent)

Yes, watered down. Just as there is some truly dire popular music there out there, there is also dull and unimaginitive classical music. In my personal opinion serious orchestral music hit the buffers in the railway station when it went atonal and eschewed melody and the ability to tug at the heart. The audiences fled, understandably. But there is a huge amount of truly beautiful music, operatic, orchestral, chamber and solo instrumental music that carries you away to another place, stirs the imaginatination, calms you then excites you, spurs the imagination, leaves you happy that life isn’t forever ordinary and humdrum. Put aside the cellphones and Facebook and experience it! It will be an Epicurean moment.

P.S: I go to the gym and am assaulted on a Sunday by the spin cycling class next door. This class is accompanied by the most repetitive and unimaginitive music I have ever heard. The chord sequences are I-V-I- V-I-V for a solid hour. Talented writing it is not. I feel like handing out to the cycling exercisers free tickets to a Chopin recital or a Beethoven symphony – if only they could cycle to them.