Dear Pharma Industry

[Its Z]

Pfizer had to pay $2.3 billion in penalties for illegal marketing of Zyvox and other drugs. Novartis just settled on $420 million for off label marketing of their drugs.

And as long as you have 25 year old drug reps running around trying to make bonus, they'll lie, steal, and cheat to sell.

Stop this marketing practice and you'll add more profit to your EBITDA.

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[1ive2die]

Dear Pharmacists,

Without the Pharma industry you would still be sitting there with your mortar and pestle grinding herbs and giving them to people to treat cancer.

Sorry I'm a Pharma sympathizer.

 

[Its Z]

dear reading comprehension challenged.

I brought up their "marketing" practice requires a reform... didn't say the pharma industry needs to go away. There's nothing wrong with promoting appropriate drug use with appropriate information. But as long as they're using "sex" and dishonest reps motivated by financial bonus as tools to buy off prescriber to market their drugs, these companies are vulnerable to hefty penalty from the FDA...

 

[All4MyDaughter]

dear pharmacists,

without the pharma industry you would still be sitting there with your mortar and pestle grinding herbs and giving them to people to treat cancer.

Sorry i'm a pharma sympathizer.

bs.

 

[All4MyDaughter]

dear reading comprehension challenged.

I brought up their "marketing" practice requires a reform... didn't say the pharma industry needs to go away. There's nothing wrong with promoting appropriate drug use with appropriate information. But as long as they're using "sex" and dishonest reps motivated by financial bonus as tools to buy off prescriber to market their drugs, these companies are vulnerable to hefty penalty from the FDA...

Let's talk about samples. Ooooh, free stuff, right? I hate samples. I worked at a low income clinic last month and time and time again, the doctors started a patient on a medication that they could NEVER afford and is not on our Medicaid formulary. All because that cute girl in the high heels put Micardis (or whatever) in the closet. So the patient got a free month of Micardis, but at the end of the month it falls to the pharmacy to explain to the patient that it isn't covered, contact the doctor for a new prescription for Lisinopril, etc. If the doctor had just STARTED the patient on Lisinopril, it would have cost the patient only $1. So tell me again why it was essential to start them on Micardis when there was no hope for long term continuation of that therapy??

 

[Its Z]

How cute was she??

 

[crazybob]

Let's talk about samples. Ooooh, free stuff, right?

Free stuff like donuts and pens? And notepads?

 

[crazybob]

So the patient got a free month of Micardis, but at the end of the month it falls to the pharmacy to explain to the patient that it isn't covered, contact the doctor for a new prescription for Lisinopril, etc. If the doctor had just STARTED the patient on Lisinopril, it would have cost the patient only $1. So tell me again why it was essential to start them on Micardis when there was no hope for long term continuation of that therapy??

Isn't it common to start them on ACEI and then switch to an ARB after a PA, and then switch to Tekturna if that doesn't work?

 

[1ive2die]

Dear clearly uninformed pre-pharmacy student,

Since you are a sympathizer, I would expect you to know that certain pharma companies spend more on marketing than R&D. I would also expect you to know that pharma companies cannot market a drug for an off-label use. A doctor can write a script for an off-label use, but a pharma company can't go and advertise that off-label use. You would also know that pharma companies do their best to push through the pre-clinical, clinical, NDA process as fast as possible to get their patents to make billions of dollars and that when those patents run out, they decide that if they change one piece of the molecule to make an isomer of that molecule, they can continue to make billions.

If they are so evil why do you keep dispensing their drugs? By saying that they spend so much on marketing and rush the clinical trial process you are saying that their drugs are somehow faulty and have to be "sold" to the general public.

I have never understood the hatred pharmacists have for pharmaceutical companies. They hate pharmaceutical companies more than the general public does. Even though a pharmacist's livelihood depends on a pharmaceutical company coming out with a new drug or a generic company producing an existing drug.

On another note what is it with people being opposed to pharmaceutical companies making money. No other industry in the world is criticized for making money even though many do it in a far more unethical way then pharmaceutical companies do. It seems just because they make medicine they should be non-profit. Imagine if someone came into your pharmacy and demanded their prescription be filled at cost or for free because they "really need it". You would laugh them out of the store. Why then can't pharmaceutical companies sell their product for a profit?

 

[apteryx]

I really wasn't going to say anything, but you must be somewhat reading comprehension-challenged to continue on with a post like that. Z further reiterated that the illegal marketing practices employed by some drug reps are subject to fines. Not the entire scope of a pharmaceutical company.

Also, mixing health care and business is not quite the same as any other industry that tries to make money. Samsung selling plasma TVs at a premium because it's an in-demand commodity has no effect on a person's well-being. However, side effects and improper dosing for an indication due to maximizing profit margins for your employees/shareholders that have the potential for injury and death should not fall into cutthroat, yet viable business strategies.

And I don't say this to try to "one-up" you, only to help you see the point here. Healthcare should be more than a business opportunity. Profit isn't a problem as long as you aren't harming people.

 

[297point1]

If they are so evil why do you keep dispensing their drugs?

Please please please be a student at some other school besides this one...

 

[owlegrad]

Please please please be a student at some other school besides this one...

 

[Its Z]

If they are so evil why do you keep dispensing their drugs? By saying that they spend so much on marketing and rush the clinical trial process you are saying that their drugs are somehow faulty and have to be "sold" to the general public.

who said pharma is evil? Maybe you're too young to remember the COX II inhibitor debacle that cost pharma an arm and a leg... but what's your excuse for not understanding what's going on with rosiglitazone and post marketing ADR???

I have never understood the hatred pharmacists have for pharmaceutical companies. They hate pharmaceutical companies more than the general public does. Even though a pharmacist's livelihood depends on a pharmaceutical company coming out with a new drug or a generic company producing an existing drug.

We don't hate pharma. We hate their illegal marketing practice.

On another note what is it with people being opposed to pharmaceutical companies making money.

Who's opposed to pharma making money??

No other industry in the world is criticized for making money even though many do it in a far more unethical way then pharmaceutical companies do.

Are you serious???? Many different industries are criticized constantly..the insurance industry..tobacco industry..fast food industry... weapons industry. How dumb are you?

It seems just because they make medicine they should be non-profit. Imagine if someone came into your pharmacy and demanded their prescription be filled at cost or for free because they "really need it". You would laugh them out of the store. Why then can't pharmaceutical companies sell their product for a profit?

mmmmm... you should repeat high school...

 

[owlegrad]

Let's talk about samples. Ooooh, free stuff, right? I hate samples. I worked at a low income clinic last month and time and time again, the doctors started a patient on a medication that they could NEVER afford and is not on our Medicaid formulary. All because that cute girl in the high heels put Micardis (or whatever) in the closet. So the patient got a free month of Micardis, but at the end of the month it falls to the pharmacy to explain to the patient that it isn't covered, contact the doctor for a new prescription for Lisinopril, etc. If the doctor had just STARTED the patient on Lisinopril, it would have cost the patient only $1. So tell me again why it was essential to start them on Micardis when there was no hope for long term continuation of that therapy??

I also hate samples. I also hated an indigent program my CVS participated in that gave qualifying patients 7 days worth of medication at cost to them. Big whoop. After 7 days, then what? I saw patients getting 7 days worth of antihypertensives, antibiotics, cholesterol medication, etc. Whats the point? Also humorous is the doctors would write for lower dosing during the first 7 days (which the hospital would pay) then increase the dosing after that (for the patient to pay). Real classy.

 

[Its Z]

oh.... you're Canadian... that figures.. eh?

 

[rxlea]

I also hate samples. I also hated an indigent program my CVS participated in that gave qualifying patients 7 days worth of medication at cost to them. Big whoop. After 7 days, then what? I saw patients getting 7 days worth of antihypertensives, antibiotics, cholesterol medication, etc. Whats the point? Also humorous is the doctors would write for lower dosing during the first 7 days (which the hospital would pay) then increase the dosing after that (for the patient to pay). Real classy.

Especially psych med samples that aren't covered by the patients' insurance. When the samples run out, what then?

oh.... you're Canadian... that figures.. eh?

I saw that too

 

[samuricool]

This is entertaining.

 

[All4MyDaughter]

Isn't it common to start them on ACEI and then switch to an ARB after a PA, and then switch to Tekturna if that doesn't work?

Yes... I'm not sure why you're asking. My point was that the patient was started on Micardis because that's what was in "the closet." There is no reason to start them on that particular (very expensive) drug except Hottie Rep brought samples and flirted with the doctor.

Yes, all ARBs require a PA on our state medicaid.

I have never (ever) dispensed Tekturna so I'm not willing to say it's "common" to switch patients to that.

 

[owlegrad]

Yes... I'm not sure why you're asking. My point was that the patient was started on Micardis because that's what was in "the closet." There is no reason to start them on that particular (very expensive) drug except Hottie Rep brought samples and flirted with the doctor.

Yes, all ARBs require a PA on our state medicaid.

I have never (ever) dispensed Tekturna so I'm not willing to say it's "common" to switch patients to that.

Really? I have seen patients on this. I wouldn't say it's common, but certainly not unheard of.

 

[All4MyDaughter]

Really? I have seen patients on this. I wouldn't say it's common, but certainly not unheard of.

I work for the VA (my real job as opposed to rotations). If we have Tekturna, it's most certainly nonformulary and would have stringent criteria for use. I only said that *I* have never dispensed it.

I didn't see it on my Advanced Community pharmacy rotation last block either (that's the place with all the drug reps and the darn Micardis). It was at a government run low income clinic and pharmacy. Almost all Medicaid.

My current rotation is at the state psychiatric hospital and they DEFINITELY don't have Tekturna.

I'm sure some people in this community are on it. Just not at the places I've been lately.

 

[IndustryPharmD]

Pfizer had to pay $2.3 billion in penalties for illegal marketing of Zyvox and other drugs. Novartis just settled on $420 million for off label marketing of their drugs.

And as long as you have 25 year old drug reps running around trying to make bonus, they'll lie, steal, and cheat to sell.

Stop this marketing practice and you'll add more profit to your EBITDA.

Eh, you think it's easy to handle reps? When only 20% of them actually say what they are supposed to say, no matter how you try to explain it to them? Reps are as much a pain to the company as they are to everyone else, but they are a necessary evil as they still bring in a good return on the investment if used properly.

And don't forget, all the lawsuits are about things that were happening back in the good ol' days. World hasn't been the same for the last four or five years... and reps are being laid off and/or managed out by thousands every eyar.

 

[Its Z]

Eh, you think it's easy to handle reps? When only 20% of them actually say what they are supposed to say, no matter how you try to explain it to them?

My point exactly.

Reps are as much a pain to the company as they are to everyone else, but they are a necessary evil as they still bring in a good return on the investment if used properly.

I think they're a liability more so than ever with stricter marketing rules.

And don't forget, all the lawsuits are about things that were happening back in the good ol' days. World hasn't been the same for the last four or five years... and reps are being laid off and/or managed out by thousands every eyar.

But Pfizer reps are still out there doing the same crap. Even after the hefty payout.

 

[IndustryPharmD]

I think they're a liability more so than ever with stricter marketing rules.

As any other decision, it all comes down to the exact numbers. If it makes fiscal sense - it's a yay, if it doesn't, it's a nay however great or awful an idea might be on its own. Just like I have personally recommended a kill on a program that would have really helped patients but wouldn't make sense financially, I would have personally recommended a pass on a program if the payout made sense even when risk of legal liability was monetized. Think about it, we all as pharmacists face a risk of legal liability for a frigging typo, but our pay and overall job makes it worth the risk. No different.

But Pfizer reps are still out there doing the same crap. Even after the hefty payout.

That's PFIZER. Now that's one of the companies I don't feel sorry for, even after they absorbed Wyeth, who I always have had a soft spot for. Pfizer and AstraZeneca are probably my two least-favorites out there. Nothing business, it's just personal.

 

[Its Z]

More importantly....since you're such a Euro fan... I'm really worked up over how the US is getting killed in the Ryder Cup... I may have a stroke or a heart attack..

But, I'm thinking about making a weekend out of going over to London to see Love Never Dies despite it not receiving rave reviews... cuz I'm a big Phantom fan.

 

[IndustryPharmD]

More importantly....since you're such a Euro fan... I'm really worked up over how the US is getting killed in the Ryder Cup... I may have a stroke or a heart attack..

But, I'm thinking about making a weekend out of going over to London to see Love Never Dies despite it not receiving rave reviews... cuz I'm a big Phantom fan.

Eh, golf. The only think worse than golf as a spectator sport is baseball.

Yeah, London. I have seriously considered flying there for a weekend this spring to see an exhibit they had of Indian jewelry, all from private collections just shown for a couple months, but that Icelandic volcano decided to go off, and then I got hot and heavy interviewing for a new job, so it never happened... That, and the fact that I am morally against spending almost as much, if not more, time getting somewhere and back than I get to spend IN that place.

I am now figuring out what to do with the week between Christmas and New Year's. I have actually been thinking about Arizona this year. A decorated conifer for X-mas is banal, a decorated palm tree is nonsensical but done to death at the southern locales, so how about I decorate a saguaro cactus for Christmas and call it a holiday? Avoiding touristy crowds is also a big factor for me.

 

[Sparda29]

The first thing the government needs to do is nerf the drug company to consumer advertising for drugs. If I had a nickel every time some elderly couple came in with questions about a drug they saw on TV that they can barely pronounce the name of...

Eh, golf. The only think worse than golf as a spectator sport is baseball.

Get out.

 

[Its Z]

A decorated conifer for X-mas is banal, a decorated palm tree is nonsensical but done to death at the southern locales, so how about I decorate a saguaro cactus for Christmas and call it a holiday?

Where would you find a saguaro cactus in East Coast?

Decorated conifer is not banal. It's a tradition. And it could be your family tradition one day...

 

[SpirivaSunrise]

More importantly....since you're such a Euro fan... I'm really worked up over how the US is getting killed in the Ryder Cup... I may have a stroke or a heart attack..

But, I'm thinking about making a weekend out of going over to London to see Love Never Dies despite it not receiving rave reviews... cuz I'm a big Phantom fan.

Do it! Get ZGirl her passport and take her. I've been to 3 shows in London...there's nothing like it.

 

[IndustryPharmD]

Where would you find a saguaro cactus in East Coast

Which is precisely why I am considering Arizona.

Decorated conifer is not banal. It's a tradition. And it could be your family tradition one day...

It already is. I have decorated a Christmas tree every year since I have learned how to walk. And I want to do something different for a change.

 

[Its Z]

Do it! Get ZGirl her passport and take her. I've been to 3 shows in London...there's nothing like it.

I may...once my year shuts down...

 

[Its Z]

Which is precisely why I am considering Arizona.

It already is. I have decorated a Christmas tree every year since I have learned how to walk. And I want to do something different for a change.

Well.... good luck carrying the cactus inside the house.

 

[Caverject]

I am now figuring out what to do with the week between Christmas and New Year's. I have actually been thinking about Arizona this year. A decorated conifer for X-mas is banal, a decorated palm tree is nonsensical but done to death at the southern locales, so how about I decorate a saguaro cactus for Christmas and call it a holiday? Avoiding touristy crowds is also a big factor for me.

I will be taking a one way direct flight from Afghanistan to Texas that week between xmas and new years and will be having the biggest celebration of Christmas and New Years San Antonio has ever seen...

 

[SpirivaSunrise]

I will be taking a one way direct flight from Afghanistan to Texas that week between xmas and new years and will be having the biggest celebration of Christmas and New Years San Antonio has ever seen...

I already ordered your Xmas gifts

 

[Its Z]

I will be taking a one way direct flight from Afghanistan to Texas that week between xmas and new years and will be having the biggest celebration of Christmas and New Years San Antonio has ever seen...

Yes Sir! You just come home safe young man. Can't wait to see y'all in your fancy new minivan!

 

[MountainPharmD]

Yes Sir! You just come home safe young man. Can't wait to see y'all in your fancy new minivan!

You got a problem with minivans? I got stow and go seating baby!!! I have 3 cars seats and I can fit in three adults. I'd like to see you try that in your fancy shmacy elitist porsche!

 

[SpirivaSunrise]

You got a problem with minivans? I got stow and go seating baby!!! I have 3 cars seats and I can fit in three adults. I'd like to see you try that in your fancy shmacy elitist porsche!

Think Z's mentioned that he has a minivan?

For the record...I am going SUV all the way when I have kids. No way jose on the minivan.

 

[Its Z]

You got a problem with minivans? I got stow and go seating baby!!! I have 3 cars seats and I can fit in three adults. I'd like to see you try that in your fancy shmacy elitist porsche!

Ehhh....shut up foo !

I've had a minivan even before you started pharmacy school !

 

[Its Z]

Think Z's mentioned that he has a minivan?

For the record...I am going SUV all the way when I have kids. No way jose on the minivan.

You do what you gotta do... but you can't beat the automatic sliding doors on minivans for loading up kids. Try opening the back doors in an SUV in a tight parking space when wind is blowing... and it's those damn soccer moms in SUV that cause door dings on others!

Also, seat height is such that minivan allows an easy seating of babies and kids while putting a kid in a 4x4 SUV is awkward.

Once kids are around, you'll be hauling kids and family etc.. minivan allows up to 8 seating with plenty of storage...try that in an SUV..even in a suburban it isn't easy carrying 8 people..let alone try getting in on the 3rd row seat.

Also, our Oddy gets 25mpg all day long.

If you want an SUV...get one. But if you're going to haul kids, do yourself a favor and save your back...and get a minivan. People really don't care what you drive..

I told Caver to buy a minivan some years ago. He went out and got an SUV. Now he's buying a minivan.

More importantly, golf outing with 4 guys.. 4 sets of luggage and golf clubs... can't beat a minivan.

 

[lorain]

nothing beats the minivan when it comes to comfort

if you need 3rd row seating, most SUVs are horrible and meant for very little kids back there. the one suv with legit 3rd seats is the Benz GL, but that costs well over 60k, too expensive

sienna or oddysey, cant go wrong

 

[MountainPharmD]

Think Z's mentioned that he has a minivan?

For the record...I am going SUV all the way when I have kids. No way jose on the minivan.

20 years ago or so when I graduated high school I said I would never ever own a mini-van because I was never ever going to have children.

Well here we are 20 years later and I have a mini-van and children. Just for the record I do not ever want to win a million dollars in the lottery.

We looked at SUV's and they are totally impractical. There is a reason for the mini-vans popularity. Try wrangling three kids into thier car seats in an SUV.

 

[Sparda29]

20 years ago or so when I graduated high school I said I would never ever own a mini-van because I was never ever going to have children.

Well here we are 20 years later and I have a mini-van and children. Just for the record I do not ever want to win a million dollars in the lottery.

We looked at SUV's and they are totally impractical. There is a reason for the mini-vans popularity. Try wrangling three kids into thier car seats in an SUV.

Sparda will be driving an Audi RS6 with child seats.

 

[Its Z]

20 years ago or so when I graduated high school I said I would never ever own a mini-van because I was never ever going to have children.

Well here we are 20 years later and I have a mini-van and children. Just for the record I do not ever want to win a million dollars in the lottery.

We looked at SUV's and they are totally impractical. There is a reason for the mini-vans popularity. Try wrangling three kids into thier car seats in an SUV.

Sadly, I said the same thing. No Kids and No Minivan.

Here I am today.

 

[Its Z]

Actually, when we had our first baby, I was driving a Tahoe. Sold that sucka pretty quickly when I realized how hard it was to put the baby in the baby seat in a Tahoe.

 

[SpirivaSunrise]

20 years ago or so when I graduated high school I said I would never ever own a mini-van because I was never ever going to have children.

Well here we are 20 years later and I have a mini-van and children. Just for the record I do not ever want to win a million dollars in the lottery.

We looked at SUV's and they are totally impractical. There is a reason for the mini-vans popularity. Try wrangling three kids into thier car seats in an SUV.

Well, 20 years ago I said I'd have a few kids by now and a minivan. Here we are 20 years later, and no kids...no minivan.

In all seriousness...why don't they build SUV's with swivel bucket seats in the back allowing for easy load and unloading?

 

[All4MyDaughter]

Well, 20 years ago I said I'd have a few kids by now and a minivan. Here we are 20 years later, and no kids...no minivan.

In all seriousness...why don't they build SUV's with swivel bucket seats in the back allowing for easy load and unloading?

I've seen SUV's where the middle seat in the 2nd row is removable so kids can climb into the third row of seats easier.

 

[Its Z]

Well, 20 years ago I said I'd have a few kids by now and a minivan. Here we are 20 years later, and no kids...no minivan.

In all seriousness...why don't they build SUV's with swivel bucket seats in the back allowing for easy load and unloading?

It's kinda hard to explain this to a girl, since you have no concept of this.... but a larger SUV sits on truck chasis (rougher ride and taller) plus since it's a rear wheel drive, it requires a drive shaft from the front mounted transmission to the rear axle and this takes up a lot of space under the floor. Hence there is less available space...

Now minivan which is typically a front wheel drive, it sits on a front wheel passenger vehicle type of chasis... lighter and more functional in building a people hauler.

Of course there are crossovers that tries to mimic a minivan/stationwagon/suv... But I haven't seen one as functional as a minivan.

hth.

 

[Its Z]

I've seen SUV's where the middle seat in the 2nd row is removable so kids can climb into the third row of seats easier.

whereas kids can simply walk through a gap between the 2nd row seats in an Odyssey to get to the 3rd row.

 

[SpirivaSunrise]

It's kinda hard to explain this to a girl, since you have no concept of this.... but a larger SUV sits on truck chasis (rougher ride and taller) plus since it's a rear wheel drive, it requires a drive shaft from the front mounted transmission to the rear axle and this takes up a lot of space under the floor. Hence there is less available space...

Now minivan which is typically a front wheel drive, it sits on a front wheel passenger vehicle type of chasis... lighter and more functional in building a people hauler.

Of course there are crossovers that tries to mimic a minivan/stationwagon/suv... But I haven't seen one as functional as a minivan.

hth.

LOL. Jerk. There was nothing in that post that I didn't already know.

Highlander is perfect example of SUV with the Camry chasis.

In general, I always park further out in a lot anyways...away from dings and traffic congestion. I don't mind walkin'...it's good for ya. And I'll do it with a baby in one arm too.

 

[Its Z]

Highlander is perfect example of SUV with the Camry chasis.

Highlander is a poor excuse of an SUV. Might as well call it the Camry Stationwagon. Really..what's the difference between Venza and Highlander?

 

[SpirivaSunrise]

Highlander is a poor excuse of an SUV. Might as well call it the Camry Stationwagon. Really..what's the difference between Venza and Highlander?

Come on...

Venza is 63.4"

Highlander is full 6" taller